腹腔镜膀胱癌根治术的治疗效果及对血清前梯度蛋白-2的影响及其意义

目的:探讨腹腔镜膀胱癌根治术的治疗效果及对血清前梯度蛋白-2(AGR2)的影响及其意义。方法:选取2013年3月～2016年5月我院收治的80例膀胱癌患者为研究对象,同时选取同期体检健康的志愿者30例作对照组。膀胱癌患者择期行腹腔镜根治术,观察手术时间、术中出血量、术后肠道排气时间、住院时间和术后并发症。采用ELISA法检测膀胱癌患者术前和术后4周血清AGR2水平的变化。术后随访至2017年12月25日,分析血清AGR2水平与患者总生存期(OS)和无进展生存期(PFS)的关系。结果:80例患者顺利完成腹腔镜根治术,无中转开放手术,无死亡,手术时间(359.8±45.7)min,术中出血量(423.8±109.4)mL,术后肠道排气时间(3.2±1.4)d,术后住院时间(12.9±2.4)d。膀胱癌患者术前血清AGR2水平显著高于对照组(33.5±9.4) vs.(8.5±2.1)ng/m L,P0.05],术后4周血清AGR2较术前显著降低(17.8±4.1) vs.(33.5±9.4) ng/mL,P0.05]。术后4周血清AGR2低水平患者PFS(23vs14月,P0.05)和OS (36vs23月,P0.05)均显著大于高水平患者(P0.05)。结论:腹腔镜膀胱癌根治术治疗效果满意,可显著降低患者血清AGR2水平。血清AGR2水平的变化有助于腹腔镜根治术的治疗效果和预后预测。

Effect of Laparoscopic Radical Cystectomy for Bladder Cancer its Effect on Serum Anterior Gradient-2 and its Significance

ABSTRACT Objective: To investigate the effect of laparoscopic radical cystectomy for bladder cancer its effect on the serum anterior gradient-2 (AGR2) level and its significance. Methods: A total of 80 cases of bladder cancer patients in our hospital from March 2013 to May 2016 were selected as research subjects, while 30 healthy volunteers were selected as the control group. All of the bladder cancer patients underwent laparoscopic radical cystectomy, the operation time, intraoperative blood loss, postoperative intestinal exhaust time, hospitalization time and postoperative complications were observed. The serum AGR2 level before and after operation was detected by ELISA. The correlation of serum AGR2 level with the total survival (OS) and progression free survival (PFS) of bladder cancer patients were analyzed. Results: 80 patients successfully completed the laparoscopic radical cystectomy, no transfer to open surgery, no death. The operation time was(359.8±45.7) min, intraoperative blood losswas(423.8±109.4) mL, the postoperative intestinal exhaust time was (3.2±1.4) d, and postoperative hospitalization time was(12.9±2.4) d. The serum AGR2 of bladder cancer patients was significantly higher than that of the control group (33.5±9.4) vs. (8.5±2.1) ng/mL, P<0.05], at 4 weeks after the operation, the serum AGR2 level of bladder cancer patients was significantly lower than that before the operation (17.8±4.1) vs. (33.5±9.4) ng/mL, P<0.05]. At 4 weeks after the operation, the PFS (23 vs 14 months, P<0.05) and OS (36 vs 23 months, P<0.05) were significantly higher in patients with low level of serum AGR2. Conclusion: The curative effect of laparoscopic radical cystectomy is satisfactory, and the serum AGR2 can be sig- nificantly reduced. The change of serum AGR2 level is helpful to the prognostic prediction and herapeutic effect evaluation of laparo- scopic radical cystectomy.